EM Cases · Paediatric respiratory distress
Paediatric respiratory distress — the severe asthma resus station
An ACEM Fellowship OSCE clinical-management (resus) station. Tests the structured airway-breathing-circulation approach, weight-based paediatric drug dosing from the Broselow tape or age formula, the paediatric asthma escalation ladder (salbutamol, ipratropium, systemic steroid, intravenous magnesium), the recognition of the life-threatening signs (silent chest, exhaustion, rising CO₂), and the threshold for intubation. Maps to the OSCE clinical-management domain. ACEM-primary, globally tagged.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A 6-year-old in acute severe asthma who fails to respond to first-line therapy and tires toward a life-threatening arrest, testing weight-based dosing and the escalation ladder.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
References4ShowHide
- [7]Griffiths B, Ducharme FM. Combined inhaled anticholinergics and short-acting beta2-agonists for initial treatment of acute asthma in children. Cochrane Database of Systematic Reviews, 2013.PMID 23966133
- [10]Schuh S, O'Shea S, Freedman SB, et al. Magnesium in acute pediatric asthma in the emergency department (MAGICIAN) — a multicentre randomized controlled trial. PLOS ONE, 2026.PMID 42234723
- [24]Ciarallo L, Sauer AH, Shannon MW Intravenous magnesium therapy for moderate to severe pediatric asthma: results of a randomized, placebo-controlled trial. The Journal of pediatrics, 1996.PMID 8969721
- [25]Craig SS, Dalziel SR, Powell CV, et al. Interventions for escalation of therapy for acute exacerbations of asthma in children: an overview of Cochrane Reviews. Cochrane database of systematic reviews, 2020.PMID 32767571